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Step 3 Board Review Material > MTB Infectious Disease > Flashcards

MTB Infectious Disease Flashcards

1
Q

What is the treatment for MRSA

A

Vancomycin
Linezolid
Daptomycin

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2
Q

What is the treatment for cellulits

A

minor dz: dicloxacillin or cephalexin
Pen allergic: macrolides or clindamycin

Severe dz: Oxacillin, nafcillin, cefazolin
Pen allergic: Vancomycin or Daptomycin

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3
Q

What is the treatment for gonorhea or chlamydia

A

Always treat both as it is a common co-infection

  1. ceftriaxone for gonorrhea (can use cipro)
  2. Azithromycin for chlamydia
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4
Q

What antibiotics are safe in pregnancy

A 
Penicillin
Cephalosporins
aztreonam
Erythromycin
Azythromycin
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5
Q

What is the treatment for syphilis

A

2.4 million units IM of Penicillin G benazathine

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6
Q

What is the treatment for syphilis in the penicillin allergic patient

A

Doxycycline 100mg PO q12hrs x 14 days

For pregnancy or tertiary syphilis the only treatment is penicillin desensitization

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7
Q

What is the treatment for a Jarisch-Herxheimer reaction

A

aspirin and continue treatment against syphilis

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8
Q

What test should be run for suspected syphilis if an RPR or VDRL is negative

A

Darkfield microscopy

25% of RPR and VDRL are negative

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9
Q

What symptoms are present with cystitis

A

Dysuria
WBC in Urine
Suprapubic tenderness

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10
Q

What symptoms are present with pyelonephritis

A

Dysuria
WBC in Urine
Flank pain
Fever

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11
Q

What should be considered when a pyelonephritis does not respond to treatment

A

Perinephric abscess

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12
Q

How is endocarditis diagnosed clinically

A

Presence of:

  • 2 Major criteria or,
  • 1 Major and 3 minor criteria or,
  • 5 minor criteria
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13
Q

What are the major Criteria associated with Dukes classification of Infective Endocarditis

A

2) Abnormal Echocardiagram
- Intracardiac mass
- abcess
- partial dehiscence of prosthetic valve

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14
Q

What are the minor Criteria associated with Dukes classification of Infective Endocarditis

A
  1. Fever > 38c
  2. Presence of risk factors
  3. Vascular findings
  4. Immunological findings
  5. Microbiological findings insufficient for a major criteria
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15
Q

What are the vascular findings associated with infective endocarditis

A
  1. Janeway lesions (flat and painless in hands and feet)
  2. Septic pulmonary infarct
  3. arterial emboli
  4. mycotic aneurism
  5. Conjonctival Hemorhage
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16
Q

What are the immunological findings associated with Infective Endocarditis

A
  1. Roth Spots (Retina)
  2. Osler Nodes (raised, painful, pea shaped)
  3. glomerular nephritis
17
Q

When should therapy for HIV be started

A
  1. CD4 < 500
  2. Symptomatic patients
  3. Pregnant Women
  4. Needle stick by known HIV positive pt
18
Q

What is the recommended therapy for starting a patient with HIV

A

HAART (one of the following combinations)

  1. Tenofovir + entricitabine + efavirenz (single pill combination)
  2. Zidovudine + lamuvudine + efavirenze
  3. Zidovudine + lamuvudine + ritonavir/lopinavir

*** Never use AZT (zidovudine) as a mono therapy

19
Q

What are the adverse effects of NRTI class

A

lactic acidosis

20
Q

What are the adverse effects of Protease Inhibitors

A

hyperglycemia

hyperlipidemia

21
Q

What are the adverse effects of NNRTI class

A

drowsiness

22
Q

What are the adverse effects of zidovudine

A

anemia

23
Q

What are the adverse effects of didanosine

A

pancreatitis

neuropathy

24
Q

What are the adverse effects of stavudine

A

pancreatitis

neuropathy

25
Q

What are the adverse effects of abacavir

A

rash

26
Q

What are the adverse effects of indinavir

A

kidney stones

27
Q

Name the NRTI’s

A 
zidovudine
didanosine
stavudine
lamivudine
abacavir
emtricitabine
tenofovir
28
Q

Name the Protease Inhibitors

A 
Indinavir
ritonavir
lopinavir
Nelfinavir
Saquinavir
Darunavir
Tipranavir
Amprenavir
Atazanavir
29
Q

Name the NNRTI’s

A

Efavirenz
Nevirapine
Etravirine
Rilpivirine

30
Q

What is the treatment for post exposure prophylaxis to to HIV

A

HAART for one month

31
Q

If a pt is diagnosed as HIV positive during the routine pregnancy and is not currently on treatment what options are available

A
  1. CD4 < 500: start HAART

2. CD4 > 500 and low viral load: HAART immediately is better than waiting to 2nd or 3rd trimester

32
Q

When should prophylaxis be initiated for HIV positive patients

A

CD4 < 200: TMP/SMX against Pneumocystis Jiroveci Pneumonia

CD4 <50: Azithromycin once a week against Myconacterium avium Intracellular

33
Q

How will an HIV + patient present when infected with PCP

A

Shortness of breath
Dry cough
Hypoxia
Increased LDH

34
Q

How is PCP diagnosed

A

Bronchoalvolar lavage

CXR will demonstrate increased interstitial markings bilaterally

35
Q

What should be considered in an HIV patient with nausea, vomiting, headache and focal neurological deficits?

A

Toxoplasmosis
PML (progressive multifocal leukoencepholapathy)

Contrast head CT will show Ring enhancing lesions in Toxoplasmosis

36
Q

What treatment is needed for an HIV patient with a CD4 count < 50 that presents with blurry vision?

A

Patient requires dilated opthomalogic evaluation

If treatment is needed for CMV use valgancyclovir

37
Q

If an HIV patient presents to the ER with fever, headache and stiff neck what is the next course of action

A

Lumbar puncture.

  • India Ink initially (60% sensitive)
  • Cryptococcal Antigen test (95% sensitive)

If positive treat with Amphotericin B followed by fluconazole

38
Q

What are the opportunistic infections associated with HIV

A

CD4 < 300: Candidal Esophogitis

CD4 < 200: (PCP) Pneumocystis Jiroveci Pneumonia

CD4 <50: CMV, Mycobacterium avium Intracellular

Step 3 Board Review Material (2 decks)

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